Healthcare Provider Details

I. General information

NPI: 1831226430
Provider Name (Legal Business Name): CHILDREN'S HEALTHCARE ASSOCIATES, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 08/25/2020
Certification Date: 08/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 MEDI PARK DR STE 2001
AMARILLO TX
79106-2108
US

IV. Provider business mailing address

1901 MEDI PARK DR STE 2001
AMARILLO TX
79106-2108
US

V. Phone/Fax

Practice location:
  • Phone: 806-468-4350
  • Fax: 806-468-4351
Mailing address:
  • Phone: 806-468-4350
  • Fax: 806-468-4351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberK1129
License Number StateTX

VIII. Authorized Official

Name: DR. CARMEN M WERNER
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 806-468-4350